Chapter 12 1. Order: Prednisone 0.15 mg/kg PO daily. The label on the bottle reads 2.5 mg/tab, and the child weighs 110 pounds. Calculate the number of tablets that you should administer. 1. 6 tablets 2. 14 1/2 tablets 3. 3 tablets 4. 18 tablets Answer: 3 Rationale: 110 ÷ 2.2 = 50 kg, 7.5 mg. 2. Order: Pen-Vee K (penicillin V potassium) 7.5 mg/kg PO, daily q.4h. The medication is supplied in 125 mg/tab, 250 mg/tab, and 500 mg/tab. Using the minimum number of tablets, how many tablets, and of which strength, will you administer to a child who weighs 110 pounds? 1. Three 125mg tablets 2. One 250mg tablet and one 125mg tablet 3. One 500mg tablet, one 250mg tablet, and 3/5 of a 125mg tablet 4. Three 250mg tablets Answer: 2 Rationale: 375 mg per dose. 3. Order: Phenobarbital sodium 4 mg/kg PO, daily at bedtime. The label on the bottle reads, "30 mg/tab." Calculate how many tablets you should administer for a child who weighs 33 pounds. 1. 2 tablets 2. 4 1/2 tablets 3. 15 tablets 4. 9 2/3 tablets Answer: 1 Rationale: 33 lb = 15 kg. 4. Order: Dilantin Kapseals (phenytoin sodium, extended) 5 mg/kg PO, extended-release capsules divided in three equal doses. The label on the bottle reads, "30 mg/cap." Calculate how many capsules you should administer for a child who weighs 40 pounds. 1. 1 capsule 2. 3 capsules 3. 2 2/3 capsules 4. 3 3/4 capsules Answer: 1 Rationale: 40 lb × kg/2.2 lb × 5 mg/ kg × 1 cap/30 mg = 3 cap ÷ 3 = 1 capsule 5. Order: Fluconazole (Diflucan) 5 mg/kg p.o. every day. The label on the bottle reads "50 mg/tablet." Calculate how many tablets you should administer for a child who weighs 44 pounds. 1. 4 2/5 tablets 2. 4 tablets 3. 12 1/2 tablets 4. 2 tablets Answer: 4 Rationale: 20 kg × 5 mg/kg = 100 mg. 6. Order: Amoxicillin oral suspension 20 mg/kg/day PO in three divided doses. The label on the bottle reads 125 mg/5 mL, and the child weighs 35 pounds. Calculate the number of milliliters that you should administer. 1. 9.3 mL 2. 4.2 mL 3. 2.5 mL 4. 12.9 mL Answer: 2 Rationale: 35 lb/1 × kg/2.2 lb × 20 mg/kg × 5 mL/125 mg = 12.8 mL. 7. Order: Ery-Ped (erythromycin ethylsuccinate) oral suspension 20 mg/kg/daily PO, in four equally divided doses. The label on the bottle reads, "400 mg/5 mL," and the child weighs 65 pounds. Calculate the number of milliliters that you should administer. 1. 3.25 mL 2. 1.2 mL 3. 8.9 mL 4. 1.8 mL Answer: 4 Rationale: 65 lb/1 × kg/2.2 lb × 20 mg/kg × 5 mL/400 mg = 7.4 mL/d. 8. Order: Amoxicillin oral suspension 40 mg/kg/day PO, in three divided doses. The label on the bottle reads, "125 mg/5 mL," and the child weighs 65 pounds. Calculate the number of milliliters that you should administer. 1. 0.14 mL 2. 34.7 mL 3. 15.7 mL 4. 47.3 mL Answer: 4 Rationale: 65 lb × kg/2.2 lb × 40 mg/kg × 5 mL/125 mg = 47.3 mL/d 9. Order: Ery-Ped (erythromycin ethylsuccinate) oral suspension 30 mg/kg/daily PO, in four equally divided doses. The label on the bottle reads, "200 mg/5 mL," and the child weighs 45 pounds. Calculate the number of milliliters that you should administer. 1. 15.3 mL 2. 5.6 mL 3. 18.6 mL 4. 2.55 mL Answer: 1 Rationale: 45 lb × kg/2.2 lb × 30 mg/kg × 5 mL/200 mg = 15.3 mL/d. 10. Order: Lasix (furosemide) oral suspension 2 mg/kg/daily PO, in four equally divided doses. The label on the bottle reads, "40 mg/5 mL," and the child weighs 11 pounds. Calculate the number of milliliters that you should administer. 1. 3.1 mL 2. 6.05 mL 3. 0.21 mL 4. 0.31 mL Answer: 4 Rationale: 11 lb = 5 kg, 5 kg × 2 mg/kg × 5 mL/40 mg = 0.31 mL. 11. Order: Claforan (cefotaxime sodium) 50 mg/kg/day IV in four equally divided doses, infuse in 50 mL DW over 30 minutes via pump. The package insert states to reconstitute the 500 mg vial with 10 mL sterile water, and the child weighs 36 kilograms. At what rate will you set the IV pump to run in milliliters per hour? 1. 100 mL/h 2. 108 mL/h 3. 118 mL/h 4. 172 mL/h Answer: 3 Rationale: 1800 mg/day in four equally divided doses = 450 mg/dose. 9 mL + 50 mL D5W = 59 mL to be infused over 30 minutes. 12. Order: Gentamicin sulfate 2.5 mg/kg IV q.12h., infuse in 20 mL DW over 1h via pump. The label on the vial reads, "10 mg/mL," and the child weighs 10 pounds. At what rate will you set the IV pump to run, in milliliters per hour? 1. 20.6 mL/h 2. 25.7 mL/h 3. 21.1 mL/h 4. 24.5 mL/h Answer: 3 Rationale: 1.136 + 20 = 21.136 mL/h. 13. A patient is to receive 1000 mL D5W at 80 mL/h. Calculate the flow rate in gtt/min. The drop factor is 20 gtt/mL. 1. 26 gtt/min 2. 33 gtt/min 3. 333 gtt/min 4. 240 gtt/min Answer: 1 Rationale: 80 mL/h × mL/20 gtt × 1 h/60 min = 26.6 gtt/min. Round down. 14. A patient is to receive 500 mg of Kefzol (cefazolin sodium) in 50 mL D5W over 30 minutes. Calculate the flow rate in mcgtt. The drop factor is 60 mcgtt/mL. 1. 50 mcgtt/min 2. 60 mcgtt/min 3. 100 mcgtt/min 4. 120 mcgtt/min Answer: 3 Rationale: 50 mL/30 min = 100 mL/h = 100 mcgtt/min. 15. A patient is to receive 250 mL D5W at 24 mL/h. Calculate the flow rate in gtt/min. The drop factor is 15 gtt/mL. 1. 30 gtt/min 2. 6 gtt/min 3. 62 gtt/min 4. 48 gtt/min Answer: 2 Rationale: 24 mL/h × 15 gtt/mL × 1 h/60 min = 6 gtt/min. Note: a rate this slow in most facilities would require use of an IV pump. 16. Order: Wellcovorin (leucovorin calcium) 10 mg/mPO stat. The label on the ampule reads 3 mg/mL. Calculate how many milliliters you will prepare for a child whose BSA is 0.96 m2. 1. 0.32 mL 2. 3.3 mL 3. 33 mL 4. 3.2 mL Answer: 4 Rationale: 0.96 m2 × 10 mg/ m2 = 9.6 17. Order: Amiodarone HCl 100 mg/m PO, daily. Calculate how many milligrams a child whose BSA is 0.8m2 should receive. 1. 80 mg 2. 125 mg 3. 8 mg 4. 12.5 mg Answer: 1 Rationale: 0.8 m2 × 100 mg/ m2 = 80 mg. 18. Order: Lomustine 100 mg/m PO, every six weeks. The label on the bottle reads, "100 mg/cap." How many capsules of this antineoplastic drug will you administer to a child whose BSA is 1 m2? 1. 1 capsule 2. 10 capsules 3. 0.1 capsule 4. 7 capsules Answer: 1 Rationale: 1 m2 × 100 mg/ m2 = 100 mg = 1 capsule 19. Order: Dronabinol 5 mg/m PO, 1 – 3 hours before chemotherapy. How many milligrams will a child whose BSA is 0.8m2 receive? 1. 4 mg 2. 6.25 mg 3. 0.4 mg 4. 0.625 mg Answer: 1 Rationale: 0.8 m2 × 5 mg/m2 = 4 mg 20. Calculate the daily rate of maintenance fluids and the hourly flow rate in mL/h for a child who weighs 8 kilograms. 1. 800 mL/day; 33 mL/h 2. 100 mL/day; 4.2 mL/h 3. 80 mL/day; 3.4 mL/h 4. 80 mL/d; 3.3 mL/h Answer: 1 Rationale: 8 kg × 100 mL/kg = 800 mL. 21. Calculate the daily rate of maintenance fluids and the hourly flow rate for a child who weighs 13 kilograms. 1. 1150 mL per day; 47.9 mL/h 2. 130 mL per day; 5.4 mL/hr 3. 650 mL per day; 27 mL/hr 4. 260 mL per day; 10.8 mL/hr Answer: 1 Rationale: (10 × 100) + (3 × 50) = 1150 mL. 22. Calculate the daily rate of maintenance fluids and the IV hourly flow rate for a child who weighs 25 kilograms. 1. 500 mL per day; 20.8 mL per hour 2. 170 mL per day; 7 mL per hour 3. 600 mL per day; 25 mL per hour 4. 1600 mL per day; 66 mL per hour Answer: 4 Rationale: (10 × 100) + (10 × 50) + (5 × 20) = 1600 mL. 23. Calculate the daily rate of maintenance fluids and the IV hourly flow rate for a child who weighs 44 pounds. 1. 1100 mL per day; 46 mL/h 2. 850 mL per day; 35 mL/h 3. 1500 mL per day; 62 mL/h 4. 1200 mL per day; 50 mL/h Answer: 3 Rationale: 44 ÷ 2.2 = 20 kg, 1000 + 500 = 1500 mL. 24. Calculate the daily rate of maintenance fluids and the IV hourly flow rate for a child who weighs 95 pounds. 1. 1960 mL per day; 80 mL/h 2. 2100 mL per day; 87.5 mL/h 3. 2500 mL per day; 104 mL/h 4. 2050 mL per day; 85 mL/h Answer: 1 Rationale: 43 kg, 1000 + 500 + 460 = 1960 mL. 25. Order: Dilantin (phenytoin) 15 mg PO q.12h. The recommended dose for children is 5 mg/kg/day divided in 2 – 3 doses. Is this order a safe dose for a child who weighs 11 pounds? ______ Answer: No Rationale: 5 kg × 5 mg/kg = 25 mg/day. 15 mg twice a day = 30 mg/day, which is too high a dosage. 26. Order: Amoxil 125 mg PO, q.8h. The recommended dose for children who weigh less than 40 kg is 25 mg/kg/day divided q.12h., or 20 mg/kg/day divided q.8h. Is this a safe dose for a child who weighs 16 pounds? ______ Answer: No Rationale: 7.3 kg; 25 mg/kg/day × 7.3 kg = 182.5 mg/day is a safe dosage. 125 mg three times a day = 375 mg ordered to be administered, which exceeds the safe dosage. 27. Order: Ceclor (cefaclor) 100 mg PO, t.i.d. The recommended dose for a child older than one month is 20 – 40 mg/kg/d in divided doses q.8h. Is the dose safe for a child who weighs 33 pounds? ______ Answer: Yes Rationale: 20 mg/kg × 15 = 300 mg; 40 mg/kg × 15 = 600 mg. Safe dosage is 300 – 600 mg/day for a 33 pound child. 100 mg given three times a day = 300 mg which is a safe dosage. 28. Order: Pediaprofen (ibuprofen) 40 mg PO, q.6h. p.r.n. temperature below 102.5°F. The label on the bottle reads, “100 mg/5 mL.” The recommended dose is 5 mg/kg q 6 – 8h, with a maximum daily dose of 40 mg/kg/d. Is this a safe dose for a child who weighs 21 pounds? ______ Answer: Yes Rationale: The maximum dose is 40 mg/kg/day. 9.5 kg × 40 mg/kg/day = 380 mg/day as the maximum dose for this child. 40 mg given four times a day = 160 mg, which is below the maximum dose, so it is safe. 29. The physician orders Garamycin (gentamicin) 25 mg IVPB q.8h. for a child. If the label on the Garamycin vial reads 5 mg/mL, how many milliliters will you withdraw from the vial to add to the volume control chamber? If the recommended concentration of the solution for infusion is 2 mg/mL, how would you then dilute the medication in the volume control chamber (VCC)? 1. 5 mL of medication and 12.5 mL of fluid 2. 125 mL of medication and 125 mL of fluid 3. 5 mL will be withdrawn from the vial and added to the VCC. And then IV fluid must be added to the VCC to the level of 12.5 mL 4. 125 mL of medication and no further fluid is needed Answer: 3 Rationale: 5 mL of medication to be added to the VCC; 25 mg × 1 mL/2 mg = 12.5 mL. 30. The physician orders vancomycin (Vancocin) 500 mg q.6h. Directions on the label instruct 500 mg vial to be diluted with 10 mL of sterile water and then further diluted with 100 mL of D5W. How many mL of fluid will there be in the VCC when medication is ready to infuse? 1. 100 mL 2. 10 mL 3. 110 mL 4. 115 mL Answer: 3 Rationale: Dilute with 10 mL sterile water and then add 100 mL of D5W = 110 mL total fluid. 31. The doctor orders Ampicillin 500 mg q6h to be administered in a volume control chamber in a total solution of 40 mL. The ampicillin vial has a strength of 100 mg/mL. After adding the ampicillin to the VCC, how many mL of fluid will you then also add to the VCC? 1. 5 mL 2. 15 mL 3. 35 mL 4. 40 mL Answer: 3 Rationale: You add 5 mL from the vial, and need another 35 mL to have a total of 40 mL. Test Bank for Dosage Calculations: A Multi-Method Approach Anthony Patrick Giangrasso, Dolores M. Shrimpton 9780132158626
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